Background: Preventable hospital readmission is a prominent consideration in policy discussions aimed at reducing morbidity and cost in the United States health care system. Research shows patients are more likely to be readmitted after discharge from hospitals with worse safety performance as reflected by a higher incidence of Patient Safety Indicators (PSIs). Hospital patient safety […]

Background: Project BOOST (Better Outcomes for Older adults through Safe Transitions) is being implemented at 30 U.S. hospitals to enhance the hospital discharge process. Pilot sites began implementing Project BOOST'S core elements in January 2009. However, given that previous research has shown that quality improvement interventions to speed implementation of evidence‐based best practice are implemented […]

Background: Up to three quarters of hospital readmissions may be avoidable, incurring a total cost from unplanned readmissions of $17.4 billion annually. Knowledge regarding the characteristics of patients at highest risk of readmission has been derived largely from single center or regional analyses. Analysis of Medicare claims data confirms previously identified patient risk factors for […]

Background: Increasing numbers of hospitalized infants and children are cared for by pediatric hospitalists. Transitions in care and transfer‐of‐care providers at the time of hospital discharge place patients at risk for failure to achieve postdischange continuity of care, which is defined as: (1) failure to comply with the prescribed discharge medical regimen and (2) failure […]

Background: Obesity is a major contributor of morbidity and all‐cause mortality, and is associated with decreased life expectancy. The long‐term risk of excessive weight gain increases during adulthood and currently more than 70% of the U.S. population is classified as overweight or obese. However, fewer than 50% of these patients report being counseled to lose […]

Background: Perioperative medicine platforms (PMPs) are being adopted by many hospitals and HMOs. Despite a growing body of evidence around pre operative medical optimization, the full impact of a dedicated preoperative consultation service on patient outcomes is unknown. Methods: A merged clinical and administrative electronic database (Enterprise Data Warehouse) at a large urban academic medical […]

Background: The use of patient safety indicators such as pressure ulcer rate, allows institutions to monitor and compare their level of efficacy with other hospitals. Medicare and Medicaid have instituted quality measures and payment based on such patient safety indicators. Case‐mix analysis, as often applied in the long‐term care setting, may play an important role […]

Background: Highly functional teams require cohesiveness, communication, role clarity, and goal clarity. Although in patient physicians and nurses may ideologically agree on the importance of teamwork, weaknesses in these domains may still exist. To understand domains of teamwork weakness in our hospital medicine units and to plan targeted interventions to build more highly functional teams, […]

Background: Obesity is an epidemic that has increased dramatically over the past 50 years in the United Stales, A disproportionate number of obese patients are admitted to hospitals, largely because of diseases associated with or worsened by their weight. There have not been any empiric studies that have assessed whether hospitalists recognize obesity in their […]

Background: Obesity is a growing epidemic in the United States. A disproportionately high percentage of the obese population is admitted to our nation's hospitals, and once admitted these patients have lengths of stay almost twice as long and cost thousands of dollars more than those of their nonobese counterparts, The opportunity to intervene on obese […]